The past two decades have seen unprecedented scientific, technical and programmatic advances in the prevention and treatment of HIV in sub-Saharan Africa. However, HIV-related stigma continues to have negative effects across the prevention and treatment continuum. Communication efforts play a central role in HIV prevention and treatment literacy, in normalizing testing and uptake of prevention technologies, and in informing stigma and its effects. As interest in treatment-as-prevention grows, it is increasingly important to assess and address the evolving HIV communication needs of young Africans in order to ensure that they are equipped with the contextualized understanding and skills to promptly access services themselves and to contribute to an enabling environment that supports HIV prevention, testing, treatment, and adherence for others. Unique longitudinal qualitative data from 47 countries, collected during a critical 18-year period (1997- 2014) in the history of the epidemic, offer an unprecedented opportunity to examine how young Africans are making sense of evolving developments in HIV prevention and treatment and to identify cultural meanings and contextual factors that inform uptake of key biomedical interventions and behavioral practices. More than 150,000 young people from across sub-Saharan Africa took part in HIV-themed scriptwriting contests held at 8 discreet time points between 1997 and 2014, creating over 75,000 narratives. The proposed project will analyze a stratified random sample of 2,681 of these narratives written at each of the time points (1997, 2000, 2002, 2005, 2008, 2011, 2013, 2014) and by young people in five countries with diverse epidemiological and sociocultural profiles (Burkina Faso, Senegal, Nigeria, Kenya and Swaziland). It will use validated, rigorous methodologies developed in an earlier NICHD-funded study that combine in-depth narrative analysis, thematic qualitative data analysis, and descriptive statistics on quantifiable characteristics of the narratives. Patterns across the narratives will illuminate the cross-national, age, and gender distribution and longitudinal evolution of young people's social representations of biomedical interventions and behavioral practices across the prevention and treatment continuum and of people living with HIV (PLWH) and women. The overall goal of the proposed project is to contribute to efforts to improve prevention and treatment and stigma-reduction outcomes among young people in sub-Saharan Africa by identifying communication needs and best practices at country levels. The study will also generate comparative findings of importance for assessing national responses to HIV and for increasing understanding of processes of sociocultural change. Research team members from the five countries with extensive experience at program and policy levels will ensure contextual sensitivity of analysis, increase their own research capacity, and disseminate findings to key national stakeholders. The research has the advantage of being readily applicable in programmatic practice as the narratives provide a goldmine of authentic scenarios for the development of culturally adapted interventions.